Development and validation of a nomogram for predicting postoperative venous thromboembolism risk in patients with hepatocellular carcinoma.

BACKGROUND

Few studies have specifically modeled the risk of venous thromboembolism (VTE) for postoperative hepatocellular carcinoma (HCC) patients, although HCC is the third leading cause of cancer death worldwide. This study aimed to develop and validate a nomogram that accurately predicts the risk of VTE in patients after HCC surgery.

AIM

To develop and validate a nomogram to accurately predict the risk of VTE in postoperative HCC patients by integrating clinical and laboratory risk factors. The model seeks to provide a user-friendly tool for identifying high-risk individuals who may benefit from targeted anticoagulation therapy, thereby improving clinical decision-making and patient outcomes.

METHODS

Data from patients who underwent HCC surgery at Chongqing University Cancer Hospital in China were analyzed. Through univariate and multivariate logistic regression analyses, independent risk factors for VTE were identified and integrated into a nomogram. The predictive performance of the nomogram was assessed receiver operating characteristic curves, calibration curves, decision curve analysis and other relevant metrics.

RESULTS

Of 905 postoperative HCC patients were included in the study. The nomogram incorporated eight independent risk factors for VTE: Karnofsky Performance Scale, base disease, cancer stage (tumor-node-metastasis), chemotherapy, D-dimer concentration, white blood cell count, hemoglobin, and fibrinogen. The C-index for the nomogram model was 0.825 in the training cohort and 0.820 in the validation cohort, indicating good discriminative ability. Calibration plots of the model revealed high concordance between the predicted probabilities and observed outcomes.

CONCLUSION

We developed and validated a novel nomogram that can accurately estimate the risk of VTE in individual postoperative HCC patients. This model can identify high-risk patients who may benefit from targeted anticoagulation therapy.